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From www.bloodjournal.org by guest on June 17, 2017. For personal use only. With this important step forward in understanding follicular lymphoma outcomes, Solal-Céligny and colleagues have brought us closer to a time when we can both provide a realistic picture of what the disease has in store for a patient and individualize the therapeutic approach for this complex disease. ■ REFERENCES 1. Horning SJ. Natural history of and therapy for the indolent non-Hodgkin’s lymphomas. Semin Oncol. 1993; 20(suppl 5):75-88. 2. Fisher RI. Current therapeutic paradigm for the treatment of non-Hodgkin’s lymphoma. Semin Oncol. 2000;27(suppl 12):2-8. 3. Peterson BA, Petroni GR, Frizzera G, et al. Prolonged single-agent versus combination chemotherapy in indolent follicular lymphomas: a study of the cancer and leukemia group B. J Clin Oncol. 2003;21:5-15. 4. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project: a predictive model for aggressive nonHodgkin’s lymphoma. N Engl J Med. 1993;329:987-994. 5. Decaudin D, Lepage E, Brousse N, et al. Low-grade stage III-IV follicular lymphoma: multivariate analysis of prognostic factors in 484 patients–a study of the groupe d’Etude des lymphomes de l’Adulte. J Clin Oncol. 1999; 17:2499-2505. ● ● ● HEMATOPOIESIS Comment on Harris et al, page 1314 Posttranscriptional regulation of posttranscriptional regulators ---------------------------------------------------------------------------------------------------------------Steve Collins FRED HUTCHINSON CANCER RESEARCH CENTER Posttranscriptional down-regulation of the expression of proteins involved in regulating mRNA processing, nuclear export, and translation occurs during retinoic acid–induced terminal granulocytic differentiation of cultured leukemia cells. studying the molecular events involved in the differentiation of leukemia cells and also likely provide insight into the molecular regulation of normal granulopoiesis. In a number of previous microarray studies, extensive changes in mRNA expression that occur during ATRA-induced differentiation of cultured promyelocytes to granulocytes have been well documented. In those studies that have combined expression microarrays with proteomics to study ATRA-induced granulocytic differentiation, generally good, although not absolutely strict, correlation has been observed between changes in mRNA ex___. pression and changes in protein expression.1 Now, in the present issue of Blood, Harris and colleagues have Matching image analysis for 2-DE. See the complete figure in the article beginsignificantly advanced ning on page 1314. yeloid leukemia cell lines induced to differentiate to granulocytes with agents such as all-trans-retinoic acid (ATRA) offer convenient in vitro model systems for M 1234 such studies using state-of-the-art quantitative proteomics (the technical details of which are nicely outlined) to document changes in protein expression that occur during the ATRAinduced differentiation of the NB4 promyelocytic leukemia cell line. They describe at least 59 proteins that are differentially expressed following ATRA treatment of these cells, with the majority of these proteins exhibiting reduced expression. Many of these down-regulated proteins are involved in posttranscriptional regulation of mRNA activity and include a number of ribonucleoproteins involved in mRNA processing and nuclear export as well as other proteins that regulate mRNA translation. Surprisingly, the authors observe that for most proteins, the ATRA-induced down-regulation of these posttranscriptional regulators occurs in the absence of any documented change in the levels of the corresponding mRNAs, which essentially remain unchanged in the uninduced versus ATRA-induced cells. Thus, the down-regulation of these posttranscriptional mRNA regulators appears to be in turn regulated by posttranscriptional mechanisms that likely involve either inhibition of mRNA translation or enhanced degradation of the translated protein product. There are several important take-home messages from this study. First, the observed frequent lack of correlation between changes in protein versus mRNA expression as granulocytic differentiation proceeds provides further evidence that relying solely on RNA expression microarrays without accompanying proteomic studies can cause one to miss significant changes in the expression levels of important molecular regulators. Second, the down-regulation of posttranscriptional mRNA regulators observed during the terminal differentiation of leukemia cells provides additional support linking enhanced activity of such mRNA regulators with the malignant phenotype. Previous observations have described enhanced expression of particular ribonucleoproteins involved in RNA processing and nuclear export in BCR/ABL–transformed hematopoietic cells.2 Moreover, malignancy in general has been linked with hyperactive mRNA translation. For example, in certain model systems, enhanced expression of an mRNA cap-binding protein eukaryotic initiation factor (eIF-4E) is oncogenic,3 and overexpression of this translational regulator is commonly observed in different human cancers.4 Indeed, the targeted inhibition of mRNA translational pathways might offer therapeutic 1 SEPTEMBER 2004 I VOLUME 104, NUMBER 5 blood From www.bloodjournal.org by guest on June 17, 2017. For personal use only. benefit in certain malignancies, and there is now renewed interest in antitumor agents such as rapamycin or related compounds that target (inhibit) specific proteins involved in translational regulation. ■ REFERENCES 1. Lian Z, Kluger Y, Greenbaum DS, et al. Genomic and proteomic analysis of the myeloid differentiation program: global analysis of gene expression during induced differentiation in the MPRO cell line. Blood. 2002;100:3209-3220. 2. Perrotti D, Calabretta B. Translational regulation by the p210 BCR/ABL oncoprotein. Oncogene. 2004;23:32223229. 3. Lazaris-Karatzas A, Sonenberg N. The mRNA 5⬘ capbinding protein, eIF-4E, cooperates with v-myc or E1A in the transformation of primary rodent fibroblasts. Mol Cell Biol. 1992;12:1234-1238. 4. De Benedetti A, Graff JR. eIF-4E expression and its role in malignancies and metastases. Oncogene. 2004;23:31893199. ● ● ● NEOPLASIA Comment on Harata et al, page 1442, and Zaza et al, page 1435 Targeting ALL leukemia ---------------------------------------------------------------------------------------------------------------Jerald P. Radich FRED HUTCHINSON CANCER RESEARCH CENTER The promise of modern molecular treatments for cancer is that the power of biotechnology will uncover new targets for therapy, killing more cancer while minimizing damage to normal tissues. Two articles in this issue of Blood suggest that these therapies live up to their promise. cute lymphoblastic leukemia (ALL) is a heterogeneous disease consisting of a wide variety of genetic lesions, including translocations, hyperdiploidy, and even normal-appearing genotypes.1,2 Successful treatment is the norm for pediatric patients, but results in adults are far less satisfying. A major research pursuit is to understand how the different genetic lesions encountered in ALL map to differences in clinical outcome and provide insight into new therapeutic options. In this issue of Blood, 2 studies use novel molecular techniques to uncover new potentially therapeutic options for subsets of this disease. Philadelphia chromosome–positive (Ph⫹) ALL occurs in 5% to 10% of pediatric cases and in approximately 25% of adult cases. In all populations, the outcomes following chemotherapy are especially dismal. Recently, the tyrosine kinase inhibitor imatinib has been shown to be effective in ALL, but responses are short-lived, usually lasting only about a month.3 Resistance in these cases often occurs from a mutation in the adenosine triphosphate (ATP)– binding domain of bcr-abl (the chimeric protein coded by the Ph chromosome), which effectively blocks the action of imatinib.4 There are some suggestions that increasing the imatinib dose may overcome resistance, at least temporarily,5 but increasing the dose too much invariably leads to toxicity, since imatinib also blocks the tyrosine kinase A blood 1 S E P T E M B E R 2 0 0 4 I V O L U M E 1 0 4 , N U M B E R 5 quantities of free imatinib, as demonstrated by in vitro culture and annexin V apoptotic assays. In addition, primary ALL cells from 4 patients were treated in vitro with the antiCD19 liposomal imatinib as well as free imatinib, and these experiments again demonstrated the superiority of the antibodyliposome imatinib. It is instructive that 2 of these ALL samples had Abl point mutations yet still were susceptible to the liposomaldelivered imatinib, suggesting that high concentrations of intracellular imatinib can indeed overcome the resistance conferred by the point mutation. Lastly, the liposomal imatinib seemed to have little effect on normal CD34⫹ as measured in colony-forming assays. Much may be learned from the “good risk” leukemia as well as the bad. The TELAML1 fusion gene occurs in approximately 25% of pediatric ALL cases and seems to identify a cohort with a favorable outlook.6 Why? It is known that de novo purine synthesis (DNPS) is higher in ALL compared with that of normal bone marrow cells and peripheral blood lymphocytes; among ALL cases, T-cell lineage ALL has greater DNPS than B-lineage ALL.7 Many drugs used in ALL (such as methotrexate and mercaptopurine) target DNPS and purine metabolism. Zaza and colleagues report on purine synthesis and metabolism in 113 pediatric ALL cases, focusing on the differences across different subtypes of ALL. Their findings are quite instructive. Among the function of other nontarget enzymes necessary for normal organ function. How, then, can one increase the imatinib effectively delivered to the ALL cell without harmful effects on normal tissue? In this issue of Blood, Harata and colleagues report a clever and novel approach to target imatinib delivery using liposomes coupled to antibodies to the CD19 antigen. CD19 is a lymphoid-restricted surface protein, which is found on virtually all Ph⫹ ALL cells as well as normal B cells. It is not found on myeloid or CD34⫹ stem cells. The authors conjugated mouse monoclonal anti-CD19 antibodies to CD19 with small (100 nM) liposomes that were manufactured to encapsulate imatinib. Using ALL cell lines, they demonstrated that these CD19-targeted liposomes bound and entered CD19⫹ cells but not CD19⫺ cells. The liposomal imatinib induced greater cell Internalization analysis of Cal-CD19-liposomes by confocal laser-scanning mideath than equal croscopy. See the complete figure in the article beginning on page 1442. 1235 From www.bloodjournal.org by guest on June 17, 2017. For personal use only. 2004 104: 1234-1235 doi:10.1182/blood-2004-06-2243 Posttranscriptional regulation of posttranscriptional regulators Steve Collins Updated information and services can be found at: http://www.bloodjournal.org/content/104/5/1234.full.html Articles on similar topics can be found in the following Blood collections Information about reproducing this article in parts or in its entirety may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#repub_requests Information about ordering reprints may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#reprints Information about subscriptions and ASH membership may be found online at: http://www.bloodjournal.org/site/subscriptions/index.xhtml Blood (print ISSN 0006-4971, online ISSN 1528-0020), is published weekly by the American Society of Hematology, 2021 L St, NW, Suite 900, Washington DC 20036. Copyright 2011 by The American Society of Hematology; all rights reserved.